To evaluate the effectiveness and safety of minimally invasive distal intrinsic release and extensor tenolysis combined with percutaneous release of proximal and distal interphalangeal joint collateral ligaments.
The procedures were performed on 5 cadaveric upper extremity specimens, followed by a full anatomical dissection to assess completeness of the targeted releases and any damage to surrounding structures.
Complete distal intrinsic release, dorsal capsule release, and distal interphalangeal collateral ligament release was performed on all specimens. We achieved complete release of all proximal interphalangeal joint collateral ligaments in 38 of 40 specimens (95%). We noted damage to nontargeted structures in 2 instances (5%).
Minimally invasive and percutaneous techniques can effectively release several structures known to cause finger stiffness with minimal damage to surrounding structures.
If similar results are seen in clinical trials, this could be a quick and easy way to increase the mobility of a stiff finger with potentially minimal morbidity.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Hand Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The functional range of motions of the finger joints.J Hand Surg Eur Vol. 2015; 40: 406-411
- Functional range of motion of the joints of the hand.J Hand Surg Am. 1990; 15: 240-243
- The effects of isolated finger stiffness on adjacent digit function.Hand (N Y). 2018; 13: 296-300
- Posttraumatic reconstruction in the hand.J Bone Joint Surg. 2007; 89: 428-435
- Selective release of the digital extensor hood to reduce intrinsic tightness in tetraplegia.J Plast Surg Hand Surg. 2011; 45: 83-89
- Intrinsic contractures of the hand.Hand Clin. 2012; 28: 81-86
- Intrinsic muscles of the fingers: function, dysfunction and surgical reconstruction.in: AAOS Instructional Course Lectures. Vol. 24. Mosby, St. Louis1975: 200-220
- Management of the stiff finger: evidence and outcomes.Clin Plast Surg. 2014; 41: 501-512
- Outcome review on the percutaneous release of the proximal interphalangeal joint accessory collateral ligaments.Orthop Rev (Pavia). 2009; 1: e19
- Percutaneous release of the post-traumatic finger joint contracture: a new technique.in: Atlas of Minimally Invasive Hand and Wrist Surgery. Vol. 4. Taylor and Francis Group, Boca Raton, FL2007: 83-88
- Results of operative intervention for finger stiffness after fracture of the hand.Hand (N Y). 2016; 11: 341-346
- Management of the stiff proximal interphalangeal joint.J Hand Surg Am. 2003; 3: 78-87
- Percutaneous release of the trigger finger: an office procedure.J Hand Surg Am. 1992; 17: 114-117
- Percutaneous fasciotomy for Dupuytren’s contracture.J Hand Surg Am. 2011; 36: 910-915
- In vitro kinematics of the proximal interphalangeal joint in the fingers after progressive disruption of the main supporting structures.Hand (N Y). 2015; 10: 425-432
- Quantifying the effect of the distal intrinsic release procedure on proximal interphalangeal joint flexion: a cadaveric study.J Hand Surg Am. 2005; 30: 1032-1038
Published online: February 15, 2019
Accepted: January 4, 2019
Received: January 18, 2018
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
© 2019 by the American Society for Surgery of the Hand. All rights reserved.